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The InnerDyne, Inc., Step® device is intended to provide dilation access for the performance of laparoscopic procedures to establish a port of entry for diagnostic, therapeutic, and operative procedures.

• Laparoscopic access to the abdominal region, both primary and secondary punctures;
• Thoracoscopic access to the thoracic cavity, both primary and secondary punctures; and
• Percutaneous access into hollow body organs with typical use in such procedures as percutaneous gastrostomy, percutaneous enterostomy, cholecystostomy, and dilation of biliary and urethral strictures.

The Step Trocar Expandable Port Step® device consists of an expandable dilator sheath assembly with an access (Veress-type) needle mounted within its lumen. The tubular member of the dilator sheath is configured so as to be axially compressed to reduce the outside diameter of the device prior to insertion. Upon use, the expanding dilator sheath/needle assembly is inserted through the abdominal/thoracic tissue into the target cavity or hollow organ.

For laparoscopic access to the abdominal/thoracic cavities, the following instructions should be utilized. After insufflation of the cavity, (if deemed necessary), the access needle is removed. The dilator cannula assembly, which consists of a blunt obturator, dilation cannula, and a pneumo valve, is inserted through the lumen of the dilator sheath which expands radially to accommodate it. This process in turn, radially expands the walls of the surrounding tissue. Following dilation the obturator is removed, leaving the expanding dilation sheath and dilator cannula in place to provide a sealed port for passage of diagnostic, therapeutic, and/or surgical instruments.

For access to hollow body organs (e.g., intragastric placement viewed as typical), the following instructions should be utilized. If endoscopic technique is utilized, an endoscope is advanced into the stomach using standard techniques, followed by stomach insufflation. An abdominal incision is made and the access needle/sheath assembly is inserted directly through the abdominal and stomach walls into the stomach. The access needle is removed and the cannula/dilator is advanced through the radially expanding sleeve. If laparoscopic technique is utilized, under laparoscopic vision the abdominal cavity is entered and the stomach site is selected for insertion of the access device. The sheath/needle assembly, is advanced into the stomach. The access needle is removed, leaving the expandable sheath in place. The dilator cannula assembly is inserted through the lumen of the dilator sheath which expands radially to accommodate it. Following dilation the dilator is removed, leaving the expandable sheath and dilator cannula in place to provide a sealed port for passage of the selected instruments. Once the desired instruments are placed, the access device cannula and expanding sheath are removed, allowing the stomach and abdominal wall to contract/relax. (Access to hollow organs other than the stomach, can be achieved following general laparoscopic technique and the access methodology described above.)

This system configuration allows the user to initially place a small diameter dilator cannula for passage of small diagnostic instruments. The dilator cannula can then be removed from the lumen of the dilator sheath while leaving the sheath inserted through the tissues. A larger diameter dilation cannula can then be inserted through the dilator sheath to create a larger port for passage of the larger operative instruments.

The device is assembled from medical grade materials under GMP conditions. Components are molded and machined by qualified suppliers. The components are assembled and secured by adhesives, welds, and mechanical interlocks. The Step® radially expanding access device is available in various lengths and working diameters to accommodate the selected size of indicated medical instruments. The subject product shall be available in both disposable and reusable forms.

The provided text is a 510(k) premarket notification for the InnerDyne Step Trocar Expandable Port, "Step®". It focuses on establishing substantial equivalence to previously marketed devices rather than presenting a study with specific acceptance criteria and performance data in the typical sense of a diagnostic or AI-powered device.

Therefore, many of the requested elements for describing acceptance criteria and a study cannot be directly extracted or are not applicable to this type of submission.

Here's a breakdown of what can be inferred and what cannot:

1. A table of acceptance criteria and the reported device performance

• Acceptance Criteria (Inferred from Substantial Equivalence Claim): The device is deemed acceptable if it is "substantially equivalent" to predicate devices in:
  • Basic design
  • Product configuration
  • Composition
  • Utilized materials
  • Function
  • Deployment
  • Warnings and precautions
  • Contraindications
  • Intended use
  • Safety and effectiveness for stated indications.
• Reported Device Performance: The document explicitly states: "From the foregoing, we conclude that the subject Step® device is as safe and effective as named predicates and currently marketed competitive devices for the stated indications." This is a qualitative claim of equivalence, not a quantitative performance metric.

2. Sample sized used for the test set and the data provenance (e.g. country of origin of the data, retrospective or prospective)

• Not Applicable. This is a premarket notification based on substantial equivalence, not a clinical study with a test set of patient data. Performance is assessed by comparing technical characteristics and intended use to existing, legally marketed devices.

3. Number of experts used to establish the ground truth for the test set and the qualifications of those experts (e.g. radiologist with 10 years of experience)

• Not Applicable. No ground truth determination on patient data is described as part of this submission. The "ground truth" for this regulatory pathway is the established safety and effectiveness of the predicate devices.

4. Adjudication method (e.g. 2+1, 3+1, none) for the test set

• Not Applicable. There is no test set or adjudication process described.

5. If a multi reader multi case (MRMC) comparative effectiveness study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

• Not Applicable. This device is a surgical access port, not an AI-assisted diagnostic tool.

6. If a standalone (i.e. algorithm only without human-in-the-loop performance) was done

• Not Applicable. This is a physical medical device, not an algorithm.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc)

• Implicit Ground Truth: The "ground truth" for this 510(k) submission is the established safety and effectiveness record of the predicate devices to which the new device is compared. This is derived from their historical marketing and regulatory clearance, which would have been based on appropriate evidence (e.g., clinical experience, scientific literature, prior studies for those predicates).

8. The sample size for the training set

• Not Applicable. There is no "training set" in the context of this type of medical device submission.

9. How the ground truth for the training set was established

• Not Applicable. See point 8.

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